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IADL are activities that are needed to live independently (e.g., doing housework, preparing meals, taking medications properly, managing finances, using a telephone).
A patient presenting with confusion may not have a neurologic problem, but rather an infection.
Two instruments for assessing ADL and IADL include the Katz ADL scale The geriatric assessment incorporates all facets of a conventional medical history, including main problem, current illness, past and current medical problems, family and social history, demographic data, and a review of systems.
The approach to the history and physical examination, however, should be specific to older persons.
In particular, topics such as nutrition, vision, hearing, fecal and urinary continence, balance and fall prevention, osteoporosis, and polypharmacy should be included in the evaluation.
In the normal aging process, there is often a decline in physiologic function that is usually not disease-related.
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Social and psychological factors may also mask classic disease presentations.